Checking your medicines after leaving hospital

Why lists can stop matching

A hospital team may start treatment, pause a regular medicine, change a dose or supply only a short course. The GP record, community pharmacy record and medicines at home do not always update at exactly the same moment.

NICE recommends that complete and accurate medicines information is passed between care settings. Patients and carers need to understand the new plan so that old supplies are not accidentally continued.

Compare the instructions with the medicines at home

Work through the paperwork and the actual medicine packets together. Ask the care team or pharmacist about any conflicting instructions.

• Which medicines were started, stopped or changed, and why?
• Is each change temporary or intended to continue?
• Are there duplicate strengths or old packs still in use?
• Is any blood test, blood-pressure check or follow-up appointment due?
• Who is responsible for issuing the next supply?
• Were allergies, previous reactions and non-prescription medicines considered?

When not to wait for a routine review

Seek timely professional advice if the instructions for an important medicine are unclear, a supply will run out, a new symptom may represent a serious reaction or the person is becoming acutely unwell. Contact the discharging team, GP, community pharmacist or NHS 111 as appropriate; call 999 in an emergency.

An independent written review can help organise the questions, but it should not delay urgent care or replace direct reconciliation by the teams responsible for the prescription.